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Tenecteplase for treatment of acute myocardial infarction
1Department of Pharmacy Practice, Medical University of South Carolina, Charleston 29425, USA. turcassn@musc.edu
Objective:
To describe the pharmacology, pharmacokinetics, efficacy, and safety of tenecteplase in reducing mortality associated with acute myocardial infarction (AMI).
Data Sources:
Published articles were identified from MEDLINE (from 1966 to December 2000) and Current Contents (all sections) searches.
Study Selection And Data Extraction:
Dose-ranging and pivotal studies were included for analysis in the clinical trials section.
Data Synthesis:
Tenecteplase is a third-generation thrombolytic indicated for the reduction of mortality associated with AMI. Tenecteplase has a longer half-life that allows for single-dose, intravenous bolus administration. Data from clinical trials support that tenecteplase is similar to alteplase in reducing 30-day mortality rates in patients who have had an AMI. In the ASSENT-2 (Assessment of the Safety and Efficacy of a New Thrombolytic) trial, patients treated with tenecteplase required fewer blood transfusions and experienced fewer episodes of noncerebral bleeding compared with those treated with alteplase.
Conclusions:
Tenecteplase is an effective thrombolytic agent for the treatment of AMI. It can be given as a single weight-based dose; however, it appears to offer no significant advantage over other agents in terms of its efficacy or rate of intracranial hemorrhage.